Organization
MIDWEST SURGICAL SPECIALTIES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA GRIMSHAW (MANAGER)
(660) 385-1008
Entity
Organization
Contact information
Practice address
1706 PROSPECT DR, MACON, MO 63552-2615
(660) 385-1008
Mailing address
1706 PROSPECT DR, PO BOX 402, MACON, MO 63552-2615
(660) 385-1008
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
02/24/2016
Last updated
02/24/2016
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